Psychological Services最新文献

{"title":"Health-related outcomes among veterans identified as being at increased risk during a crisis line contact.","authors":"Kelly A Stearns-Yoder, Molly E Penzenik, Jeri E Forster, Chelsea M Cogan, MaryGrace Lauver, Lisa A Brenner","doi":"10.1037/ser0000802","DOIUrl":"10.1037/ser0000802","url":null,"abstract":"<p><p>Research has focused on developing ways to prevent death by suicide, such as 24-hr crisis lines. The purpose of the study was to examine health-related outcomes among individuals using Veterans Crisis Line services who were evaluated to be at increased risk. Among those with identifying information, records were linked with electronic medical record and death data. 36,133 contacts were coded, and 9,010 Veteran contacts were linked to external data. For 3,331 contacts (37.0%), responders initiated a facility transport plan (FTP; self-transport). For 5,325 contacts (59.1%) responders contacted police department (PD) or emergency medical services (EMS) to facilitate transport. Among those with FTPs, 2,876 Veterans (86.3% of arranged FTPs, and 32.0% of all Veteran callers) were noted as arriving at a health care facility, versus 3,324 Veterans (62.9% of PD/EMS contacts and 36.9% of all Veteran callers) involving PD/EMS dispatch. Over 90% of Veterans in the cohort had a Veterans Health Administration (VHA) health encounter in the year prior to their first contact. Of the 769 previously unengaged Veterans, 765 lived for at least 3 months following their first contact, and 639 (83.5%) had a VHA encounter. Among identified Veterans, the age- and sex-adjusted rates for death by suicide, unintentional drug overdoses, and all causes were 370.8, 456.8, and 3,018.4 per 100,000, respectively. Among members of this high-risk cohort, self-transport resulted in arrival at health care facilities more frequently than PD/EMS transport. Although many engaged in some treatment posttransport, death rates remained high. Ongoing efforts are needed to identify novel ways to prevent suicide among this group of Veterans. (PsycInfo Database Record (c) 2024 APA, all rights reserved).</p>","PeriodicalId":20749,"journal":{"name":"Psychological Services","volume":" ","pages":"454-460"},"PeriodicalIF":1.9,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11009375/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41210627","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between psychosocial rehabilitation and recovery center service receipt and reported internalized stigma among veterans.","authors":"Alexander J Duman, Suja S Rajan, Soumita Lahiri, Projesh Ghosh, Brian Mercer","doi":"10.1037/ser0000799","DOIUrl":"10.1037/ser0000799","url":null,"abstract":"<p><p>Internalized stigma, also known as self-stigma, is negatively associated with a person's willingness to seek mental health services and follow their treatment plan. This can hinder a person's recovery, exacerbate their mental health illnesses, and reduce their quality of life. A primary directive of the Veteran Affairs Psychosocial Rehabilitation and Recovery Center (PRRC) program is to help veterans overcome their internalized stigma. This study is the first to evaluate the association between receiving PRRC services over time and veteran reported levels of internalized stigma based on Internalized Stigma of Mental Illness-Brief-10 scores using longitudinal PRRC Forms Data. The analysis was performed using a random-effects ordered logistic regression adjusting for veteran sociodemographic and clinical characteristics. Our study cohort consisted of 2,774 veterans who received PRRC services between fiscal years 2018 and 2021 and who had an intake form at the start of the PRRC service and at least one follow-up form. Our study found that veterans had lower odds of having a higher level of internalized stigma at the first follow-up relative to their intake (<i>OR</i>: 0.80; 95% CI [0.70, 0.92]), and these odds continued to decrease with each subsequent follow-up. These results potentially indicate the effectiveness of the PRRC program in reducing levels of internalized stigma among the veterans. Our study also suggests the need for greater clinical attention and resources for subgroups such as older veterans, male veterans, and veterans with posttraumatic stress disorder, anxiety, or personality disorders, who reported higher levels of internalized stigma. (PsycInfo Database Record (c) 2024 APA, all rights reserved).</p>","PeriodicalId":20749,"journal":{"name":"Psychological Services","volume":" ","pages":"426-434"},"PeriodicalIF":1.9,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10524539","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mental health treatment utilization patterns among 108,457 Afghanistan and Iraq veterans with depression.","authors":"Vanessa Panaite, Nathan J Cohen, Stephen L Luther, Dezon K Finch, Amy Alman, Susan K Schultz, Jolie Haun, Shannon R Miles, Heather G Belanger, F Andrew Kozel, Jonathan Rottenberg, Paul N Pfeiffer","doi":"10.1037/ser0000819","DOIUrl":"10.1037/ser0000819","url":null,"abstract":"<p><p>People with depression often underutilize mental health care. This study was conceived as a first step toward a clinical decision support tool that helps identify patients who are at higher risk of underutilizing care. The primary goals were to (a) describe treatment utilization patterns, early termination, and return to care; (b) identify factors associated with early termination of treatment; and (c) evaluate the accuracy of regression models to predict early termination. These goals were evaluated in a retrospective cohort analysis of 108,457 U.S. veterans who received care from the Veterans Health Administration between 2001 and 2021. Our final sample was 16.5% female with an average age of 34.5. Veterans were included if they had a depression diagnosis, a positive depression screen, and received general health care services at least a year before and after their depression diagnosis. Using treatment quality guidelines, the threshold for treatment underutilization was defined as receiving fewer than four psychotherapy sessions or less than 84 days of antidepressants. Over one fifth of veterans (21.6%) received less than the minimally recommended care for depression. The odds of underutilizing treatment increased with lack of Veterans Administration benefits, male gender, racial/ethnic minority status, and having received mental health treatment in the past (adjusted <i>OR</i> > 1.1). Posttraumatic stress disorder comorbidity correlated with increased depression treatment utilization (adjusted <i>OR</i> < .9). Models with demographic and clinical information from medical records performed modestly in classifying patients who underutilized depression treatment (area under the curve = 0.595, 95% CI [0.588, 0.603]). Most veterans in this cohort received at least the minimum recommended treatment for depression. To improve the prediction of underutilization, patient factors associated with treatment underutilization likely need to be supplemented by additional clinical information. (PsycInfo Database Record (c) 2024 APA, all rights reserved).</p>","PeriodicalId":20749,"journal":{"name":"Psychological Services","volume":" ","pages":"665-673"},"PeriodicalIF":1.9,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139651551","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surprise and delight: Response to informal versus formal mindfulness among university students with self-injury.","authors":"Julia Petrovic, Julia M Milad, Jessica Mettler, Chloe A Hamza, Nancy L Heath","doi":"10.1037/ser0000825","DOIUrl":"10.1037/ser0000825","url":null,"abstract":"<p><p>Nonsuicidal self-injury (NSSI) is defined as the deliberate destruction of one's bodily tissue without suicidal intent. Mindfulness practice is commonly incorporated into universities' stress management programming and may benefit students with a history of NSSI. However, recent findings suggest that these students may respond differentially to specific types of mindfulness practice (i.e., formal vs. informal practice). The present study qualitatively explored the acceptability of different types of mindfulness practice among university students with a history of NSSI. University students with a recent history of NSSI (<i>n</i> = 36) completed a semistructured interview following a brief mindfulness practice (i.e., either a formal body scan, formal sitting meditation, or informal practice). Reflexive thematic analysis of interview transcripts revealed five key themes. First, there appeared to be general misconceptions regarding what constitutes mindfulness practice (Theme 1). Nevertheless, within the present study, all mindfulness practices were carried out with relative ease (Theme 2). Notably, favorable physical and psychological experiences were predominant in response to informal practice (Theme 3). Preferences regarding level of guidance were more mixed in response to formal versus informal practice (Theme 4). Finally, only informal practice inspired feelings of delight and surprise following practice (Theme 5). Informal mindfulness practice is deemed highly acceptable by university students with a history of NSSI and clinicians should strongly consider emphasizing it in mindfulness-based interventions offered to these students, to provide them with the best opportunity to build a regular mindfulness practice and develop their emotion regulation abilities. (PsycInfo Database Record (c) 2024 APA, all rights reserved).</p>","PeriodicalId":20749,"journal":{"name":"Psychological Services","volume":" ","pages":"674-684"},"PeriodicalIF":1.9,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138499216","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trajectories of adolescent suicidal ideation and depressive symptoms during partial hospitalization: Clinical and demographic characteristics as predictors of change.","authors":"Roberto López, Katherine M Harris, Lauren Seibel, Sonia C Thomas, Rick N Leichtweis, Christianne Esposito-Smythers","doi":"10.1037/ser0000796","DOIUrl":"10.1037/ser0000796","url":null,"abstract":"<p><p>Partial hospital programs (PHPs) are a vital mental health service for youth at risk for suicide. Yet, few studies have examined trajectories of suicidal ideation and depressive symptoms, two important risk factors for suicidal behavior, over the course of care. Moreover, little is known about factors that may impact these trajectories among youth in PHPs. The present study examined trajectories of suicidal ideation and depressive symptoms, as well as clinical and demographic predictors of these changes, among youth enrolled in two PHPs. A sample of 253 youth (<i>M</i>_age = 15.3; SD = 1.4; range = 12-18; 68.8% female; 63.2% White; 75.1% non-Hispanic/Latino/a/x) completed repeated measures of suicidal ideation severity and depressive symptoms during treatment. Trajectories of these outcomes were examined using two separate latent growth models. Recent history of self-injurious behaviors and demographics were tested as predictors of trajectories using a taxonomic approach. Overall, suicidal ideation and depressive symptoms declined over the course of care. Sex, history of self-injury, and sexual identity were associated with variability in one or both trajectories of change. Results suggest individual variability in the rate of change among youth in PHPs. Such information may be used to aid in treatment planning and quality improvement efforts within PHPs. (PsycInfo Database Record (c) 2024 APA, all rights reserved).</p>","PeriodicalId":20749,"journal":{"name":"Psychological Services","volume":" ","pages":"444-453"},"PeriodicalIF":1.9,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10032502","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient experiences in making PTSD treatment decisions.","authors":"Sadie E Larsen, Katinka Hooyer, Shannon M Kehle-Forbes, Jessica Hamblen","doi":"10.1037/ser0000817","DOIUrl":"10.1037/ser0000817","url":null,"abstract":"<p><p>Although there is a range of effective posttraumatic stress disorder (PTSD) treatments, the number of patients who receive those treatments is disappointingly low (Finley et al., 2015; Maguen et al., 2018). Very little research has examined the patient experience of deciding on a PTSD treatment option and how that experience influences treatment preference and selection. In a sample of 12 veterans and 10 providers, we recorded the sessions in which providers discussed PTSD treatment options with their patients and then interviewed patients to ask their impressions of those same sessions. Specifically, using qualitative analysis, we sought to understand (a) patient preferences and experiences of choosing a PTSD treatment option, (b) what information patients retain from treatment planning sessions, and (c) why patients chose a given treatment. Almost all the patients in this sample chose an evidence-based psychotherapy but could remember little about the options afterward. Patients reported that providers presented options neutrally and that they made shared decisions with their providers. Most could talk through their reasons for coming to a decision and felt comfortable with the decision, but decisions were often made heuristically rather than deliberatively. Surprisingly, a few patients had a hard time explaining why they chose a specific treatment, were not conscious of their exact reasons for choosing a treatment, or seemed unable to remember why they chose a treatment. We also noticed subtle ways in which providers' discussions influenced treatment choice. Implications for practice are discussed. (PsycInfo Database Record (c) 2024 APA, all rights reserved).</p>","PeriodicalId":20749,"journal":{"name":"Psychological Services","volume":" ","pages":"529-537"},"PeriodicalIF":1.9,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11026293/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49681641","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Organizational caring as a predictor of good mental health in an operational naval environment.","authors":"Adam T Biggs, Todd R Seech, Dale W Russell","doi":"10.1037/ser0000820","DOIUrl":"10.1037/ser0000820","url":null,"abstract":"<p><p>Military service members encounter numerous stressors that adversely affect their mental health. These pervasive stressors emphasize the need to continually surveil, identify, and mitigate negative factors before they can produce cascading consequences for the individual. The present study utilized a large sample (<i>N</i> = 13,666) to identify several factors that might lead individuals to have poor mental health days in an austere naval operating environment. One quarter of respondents (<i>N</i> = 3,484; 25.49%) indicated that they had 0 poor mental health days in the preceding month, whereas one in eight (<i>N</i> = 1,868; 13.57%) indicated experiencing poor mental health every day in the preceding month. This bimodal distribution allowed for binary logistic regression to determine the relative influence of various factors in identifying individuals who reported significant mental health concerns versus those who did not. Split-half analyses also permitted replication of the data through randomized sampling and dividing data by ship class. Gender emerged as the most prominent predictor of mental health quality with females reporting poorer mental health. Meanwhile, organizational caring (a service member's belief that higher organizational levels cared about them) emerged as a protective factor. Perceptions of caring among the organizational hierarchy depended upon organizational tier; that is, a connection to the larger organization functioned as an even more robust predictor than perceptions that their local and more salient organizational structure (e.g., direct supervisor) cared about them. Taken together, this evidence helps identify factors related to mental health issues that may negatively impact military personnel on active duty. (PsycInfo Database Record (c) 2024 APA, all rights reserved).</p>","PeriodicalId":20749,"journal":{"name":"Psychological Services","volume":" ","pages":"601-612"},"PeriodicalIF":1.9,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138806660","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of the massed delivery of unified protocol for emotional disorders within an intensive outpatient program for military service members and veterans.","authors":"Andrew M Sherrill, Mansi Mehta, Samantha C Patton, Kelsey Sprang Jones, Natalie Hellman, Julie Chrysosferidis, Carly W Yasinski, Barbara O Rothbaum, Sheila A M Rauch","doi":"10.1037/ser0000833","DOIUrl":"10.1037/ser0000833","url":null,"abstract":"<p><p>Recent evidence supports the implementation of massed delivery of disorder-specific treatments in the military service member and veteran population. However, many treatment settings serve patients with a wide range of diagnoses, and often patients present with comorbid conditions. Growing evidence suggests transdiagnostic cognitive behavioral treatments are effective for a wide range of emotional disorders and may reduce barriers to access. Little is known about the feasibility and outcomes of the massed delivery of transdiagnostic treatments. The present study examined real-world outcomes of a 2-week intensive outpatient program using the Unified Protocol for emotional disorders (UP-IOP). The sample included military service members and veterans diagnosed with a range of emotional disorders, namely trauma- and stressor-related disorders, unipolar depressive disorders, and anxiety disorders. The present study examined outcomes of UP-IOP (depression, trauma-related symptom severity, and emotion dysregulation). Participants included all patients who sought UP-IOP in its first 15 months of operation (<i>N</i> = 117). A diagnosis of posttraumatic stress disorder (PTSD) was an exclusion criterion because the site had an established PTSD-specific IOP treatment option. Findings indicate UP-IOP was feasible, had 94% patient retention, and was effective in reducing symptom severity (Cohen's <i>d</i> = 0.76 for depression symptom severity, Cohen's <i>d</i> = 0.80 for trauma-related symptom severity). There was no observed reduction in emotion dysregulation over the 2-week course of treatment. The intensive transdiagnostic approach resulted in effective symptom reduction in an accelerated timeframe while minimizing patient attrition. These findings indicate massed delivery of transdiagnostic cognitive behavioral therapy (CBT) treatments should continue to be explored, especially for this population. (PsycInfo Database Record (c) 2024 APA, all rights reserved).</p>","PeriodicalId":20749,"journal":{"name":"Psychological Services","volume":" ","pages":"649-657"},"PeriodicalIF":1.9,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139425399","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Moral injury among first responders: Experience, effects, and advice in their own words.","authors":"Leanne K Knobloch, Jenny L Owens","doi":"10.1037/ser0000838","DOIUrl":"10.1037/ser0000838","url":null,"abstract":"<p><p><i>Moral injury</i> is a serious concern among first responders. Not only does moral injury occur with notable frequency among first response groups such as police, fire safety, and emergency medical personnel, but it also poses considerable mental health challenges. Despite a recent explosion of research on moral injury, the literature would benefit from a systematic investigation of how first responders describe their experiences in their own words. We conducted semistructured interviews with 36 graduates of a first responder trauma healing course. Participants described moral injury as (a) a byproduct of being a first responder, (b) occurring frequently but being difficult to identify, and (c) involving feelings of helplessness and guilt. Effects of moral injury included (a) wide-ranging negative consequences, (b) diminished self-esteem, (c) isolation from and suspicion of others, and (d) spiritual distress. When asked about the advice they would give to other people experiencing moral injury, first responders recommended (a) talking openly about the experience of moral injury, (b) being proactive in seeking help, (c) breaking free from the stigma of needing assistance, and (d) building a network of support. Taken together, these results suggest important guidelines for helping first responders cope with the aftermath of moral injury. (PsycInfo Database Record (c) 2024 APA, all rights reserved).</p>","PeriodicalId":20749,"journal":{"name":"Psychological Services","volume":" ","pages":"500-508"},"PeriodicalIF":1.9,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139564730","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Upstream suicide prevention in the U.S. Army: Noncommissioned officers' perspectives.","authors":"Lynsay Ayer, Stephanie Holliday, Robin Beckman, Lisa H Jaycox, Daniel Elinoff, Rajeev Ramchand, Denis Agniel, Emily Hoch, Lisa Wagner","doi":"10.1037/ser0000788","DOIUrl":"10.1037/ser0000788","url":null,"abstract":"<p><p>The goal of this study was to examine the factors associated with Army noncommissioned officer (NCO) experiences, attitudes, and behaviors in their role of identifying potential suicide risk factors in their fellow soldiers. To better understand the perspectives of NCOs, an anonymous survey was administered to 2,468 Army NCOs. Descriptive statistics and linear regressions were conducted to compare subgroups of NCOs. Most (71%) Army NCOs have received many (11 or more) hours of suicide prevention training, but training in soft skills that may be important for the gatekeeper role was less consistently reported. Active Component soldiers reported greater confidence in their intervention skills (Cohen's <i>d</i> = 0.25) and fewer logistical barriers (e.g., time and space to talk) to intervening with at-risk soldiers (Cohen's <i>d</i> = 0.80) compared to Reserve and National Guard soldiers. Formal coursework in mental health areas like psychology or chaplaincy was associated with a greater level of confidence in intervention skills (Cohen's <i>d</i> = 0.23) and in more frequent intervention behavior (Cohen's <i>d</i> = 0.13). Army NCO trainings should be modified to better equip soldiers with the soft skills (e.g., active listening skills and verbally and nonverbally conveying nonjudgment/acceptance and empathy) needed to have effective conversations with soldiers about suicide risk factors and other sensitive topics. Strategies used within mental health education, which appears to be a strength for NCO gatekeepers, could be used to achieve this goal. Reserve and Guard NCOs may need additional supports and tailored trainings to better fit their operational context. (PsycInfo Database Record (c) 2024 APA, all rights reserved).</p>","PeriodicalId":20749,"journal":{"name":"Psychological Services","volume":" ","pages":"435-443"},"PeriodicalIF":1.9,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9701684","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}